Provider Demographics
NPI:1033706338
Name:GONZALEZ ORTIZ, SHEILA M (MBA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:GONZALEZ ORTIZ
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 AMBERLEY PARK CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-6057
Mailing Address - Country:US
Mailing Address - Phone:321-695-0800
Mailing Address - Fax:
Practice Address - Street 1:3209 AMBERLEY PARK CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-6057
Practice Address - Country:US
Practice Address - Phone:321-695-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator